Introduction to Endodontics

Dr. Feras Aalam

Outline
What is Endodontics??
Indications
Contraindications
Steps
Instuments

Endodontic
known as "root canal treatment
"Endo" is the Greek word ="inside
"odont" is Greek ="tooth"
Endodontic treatment =treats the inside
of the tooth

The pulp
Inside the tooth, under
enamel an dentin, is a soft
tissue called the pulp
Extends from the crown of
the tooth to the tip of the
roots where it connects to
the tissues surrounding the
root
Contains
blood vessels,
nerves
connective tissue

The pulp
Ccreates the surrounding
hard tissues of the tooth
during development
The pulp is important during
a tooths growth and
development
Once a tooth is fully mature
it can survive without the
pulp, because the tooth
continues to be nourished by
the tissues surrounding it


What is endodontics??
Endodontics is that branch of dentistry
concerned with the
1.Diagnosis
2.Treatment
3.Prognosis and
4.prevention of

diseases and injuries
of the pulp and
periapical tissues
Objectives of Endodontic Treatment

Relief of pain = symptom free
To render the affected tooth biologically
acceptable and functioning without a
diagnosable pathosis
Removal of pulp from root(s) of tooth
Disinfections of root and surrounding
bone
Root canal treatment is an attempt to
retain a tooth which may otherwise
require extraction.
Indications for Endodontic
Therapy
a-Teeth with pulpal and /or priapical
pathosis.
b-Teeth with no pulpal or periapical
pathosis may need endodontic
treatment due to:
1-The need for post and core
construction to rebuild the missing
coronal portion of the tooth
2-Traumatic pulp exposure due to dental
work or accidental fracture.
Indications
3-Incomplete calcification of the pulp
chamber and root canals
4-Internal resorption.
5-Over erupted and mesially drifted
teeth when crown reduction may cause
pulp exposure.
6-Teeth retained in the mouth to
support overlay denture
7-Esthetic requirement.

1-Teeth with insufficient
periodontal support.
2-Teeth with vertical root
fracture.
3-Teeth with external root
resorption.
Contraindications for
Endodontic Therapy
4-Non restorable teeth which can not properly
function after endodontic treatment.

5-Non strategic teeth which can not serve in
occlusion or as abutments after endodontic
treatment.
6-Teeth with root canals not suitable for
instrumentation and /or periapical
surgery such as calcified or severely
curved canals.

7-Patients with systemic conditions
contraindicates surgical endodontics.
Phases of Endodontics
treatment
Diagnostic phase

Preparatory phase
(cleaning & shaping)

Obturation phase

Diagnostic phase
During this phase the condition of the tooth
is determined and the plan of treatment is
developed.
Diagnostic phase
Determine the condition of the tooth
and the plan of treatment
Clinical examinations
Percussion, pain
Deep caries
Radiographic examinations
- Periapical radiographs
Vitality test
Clinical examinations

Radiographic examinations


Periapical radiographs
Vitality test
Pulp test
Vitality pulp tests:
Electric Pulp tester (EPT)
Thermal Tests:
CO2 Ice
Cold water/Ice
Hot water
Cavity Test
Compare the reading with
the opposing or adjacent
tooth
Preparatory phase
(Cleaning & Shaping)
During this phase the condition of the tooth is
determined and the plan of treatment is developed.
Instuments needed:
Handpeice low, high speed
Endo-files
Saline
Irrigation syringe
Paper points
Calcium hydroxide
Cotton pellets
Temporaty filling
Rubber dam

Rubber dam
Rubber dam
Rubbere dam over the area to isolate the tooth, keep it
clean and free of saliva during the dental procedure
HAND PEICE


LOW SPEED HAND PEICE
HIGH SPEED HAND PEICE
Burs
Endo-files

Preparatory phase
Pulp chamber
Root canal
Preparatory phase
Determine the
working length
Radiographs
Add radiograph with
the working lenght
44 RCT of tooth #
35 RCT of tooth #
Irrigation
Paper points
Dry the canals
Temporary filling
Obturation phase
During this phase the root canals are filled
with an inert material to achieve a hermetic
seal as close as possible to the anatomic
apex.
Instuments needed
1.Gutta percha
2.Paper points
3.Spreader
4.Root canal sealer

Gutta percha
Spreader


Root canal sealer
Gutta percha Paper points
Obturation phase
44 RCT of tooth #
35 RCT of tooth #
Gutta percha
Summary
Post and core
35 Cats post & core for tooth #